Abstract Objectives The objective of the study was to assess the prevalence of knowledge level and predictors of lactational amenorrhea method (LAM) as method of contraception among women who gave birth a year prior to the study period in the Aksum town, Tigray Region. The study was cross sectional in design conducted from March 25 to April 24, 2015. Results of the study could help the design of family planning strategies. Results The knowledge status of LAM as a contraceptive method was 8.8% [95% CI 6.4–11%)]. Women who delivered at health institution (AOR = 1.4, 95% CI 1.2–4.3), attended postnatal care (AOR = 1.3, 95% CI 1.2–3.0) and visited home and counseled about family planning by health extension in the last 12 months, (AOR = 1.5, 95% CI 1.3–4.0) were more likely found knowledgeable towards LAM. Secondary and above level of the maternal education was also found a significant predictor variable with LAM as a contraceptive method (AOR = 1.2 95% CI 1.1–4.0). Our findings recommend that to address the knowledge gap of mothers; improving the uptake of maternal health services and strengthening family planning counseling at home are a key area for improving the knowledge level of LAM.